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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While meeting with a lot of people at HIMSS I started to think about what would be the next “must have” IT system that a healthcare organization would look at purchasing. When you look back at the history of IT purchases in healthcare, the Practice Management System (PMS or PM depending on your preference) was one of the first systems that most practices purchased. It was an easy buy for most people. They saw a lot of value to digitize the billing side of their practice. Adoption of practice management systems was widespread. Everyone was and is using one.

After the practice management system came the Electronic Health Record (EHR, but many could argue that EMR came before EHR, but that’s semantics in my books). Over the 10 years that I’ve been blogging about EHR software, we’ve seen the evolution of people asking if they should buy an EHR software to everyone realizing that they needed to go electronic but were trying to figure out which solution was best to $36 billion of government money which basically had the vast majority of doctors choose to hop on board EHR. While we don’t have 100% EHR adoption, we’re getting there. The market for EHR purchases is quite mature now.

With that as background, I’ve been thinking about what system or platform would be purchased next by a practice. I asked a number of people at HIMSS about this. Dr. Tom Giannulli from Kareo suggested that Care Plan Engagement could be an interesting next step. With the coming ACOs and value based reimbursement, you can see where Dr. Tom is coming from in his thinking. Plus, his term mixes the meaningful use term of patient engagement with the care plan approach that’s likely going to be required in future business models.

When I sat down with Carl Ferguson from CTG, he called the next product a Care Management System. When I heard it, I thought that this term could have staying power. The practice management system manages the practice (ie. billing). The electronic health record stores the records electronically. The Care Management System is going to be centered on the patient and the care that a patient receives.

What do you think of the term: Care Management System? There were probably a hundred products at HIMSS that have started to build a product like this. Although, I think a care management system would probably have to be a combination of a number of products out on the market today.

Regardless of what we call it, I think what will set apart the next big healthcare IT product offering is that it will be centered around the patient. A care management system by its very nature would have to be interoperable since the care is being given across multiple organizations. A care plan would make since because the patient’s at the center of the care management system and everyone could be involved in creating the care plan and ensuring that the care plan is being followed. At first take, I really like this terminology and I hope it gains some traction.

One challenge with the term Care Management System is that the abbreviation is CMS. That abbreviation is already quite popular with the government organization (CMS) and also the popular Content Management System (CMS). Although, if that’s the biggest problem with the term, then I feel pretty good about it. Although, this does make me wonder if we’ll go back to the age old integrated PM/EHR debate again when it comes to an integrated EHR/CMS. Will EHR vendors see this opportunity and offer a Care Management System module for their EHR? Some probably think they already are doing that.

The following is a guest blog post by Todd Stansfield from The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Mobile health (mHealth) is here to stay, and you don’t have to look far for proof. Patients now use mHealth to comparison shop basic healthcare services and access test results. Providers use it to increase efficiencies and lower costs. And CIOs use it to get more out of an electronic health record (EHR) while juggling new security challenges from the bring your own device (BYOD) movement.

Perhaps one of mHealth’s greatest areas of impact is providers’ bottom line. A new study finds that baby boomers and millennials prefer providers who incorporate mobile technology into their practices. Seven percent of patients responded that they are willing to leave their current provider for one who offers remote care, a move that could have a significant financial impact on independent physician practices. This is especially clear when considering that an overall 20 percent of patients reported seeing the same doctor for less than 2 years and 14 percent reported not having a doctor. Additionally, the Centers for Medicare & Medicaid Services (CMS) is now offering providers roughly $42 a month to manage care for Medicare patients with two or more chronic conditions in its Chronic Care Management program. These patients comprise two-thirds of Medicare beneficiaries. For practices with 20 eligible patients, that figure translates to over $10,000 per provider per year. Providers must use mHealth to meet some requirements of Chronic Care Management, such as offering 24-7 access to consultation, and companies are now creating technologies to help. Just last month, Qualcomm and Walgreens announced a joint venture to pair medical devices with mobile and web apps to provide remote patient monitoring and transitional care support.

And then there’s efficiency. Another study finds that “the average hospital loses $1.7 million per year due to inefficient care coordination,” according to a HealthIT Analytics article. Providers are finding mobile technology valuable for improving health information exchange and communication, areas underserved by current EHR systems. More providers are text messaging care information rather than communicating face-to-face with colleagues, resulting in more informed care teams and fewer avoidable healthcare errors. Providers are also using mobile devices to enhance real-time patient engagement rather than relying on cumbersome computers to document in the EHR. Often the result is improved patient care, shorter appointments, and more time to see more patients. And besides getting in and out of their provider’s office sooner, patients are also welcoming new efficiencies with real-time access to their medical records via smartphone, a selling point among younger generations pursuing an active role in their care. In a recent survey of Americans, millennials indicated a preference for patient portals that they can access via a smartphone or tablet.

Yet providers should plan carefully when implementing mHealth, as there are major costs for failing to set up robust infrastructures that support safe mobile use. Providers should perform security risk analysis to ensure the safety of protected health information (PHI). This includes evaluating the security of all mobile devices—tablets and smartphones—ensuring that each device stores, sends, and receives PHI securely using encryption and other methods. Providers must perform this analysis routinely to receive payments under Meaningful Use (MU) and to prevent the ever-growing number of data breaches. Data security has remained a chief concern for healthcare providers and leaders and has largely stifled the widespread adoption of mHealth. This may change as the Department of Health & Human Services plans to offer more guidance to mHealth developers and users for adhering to HIPAA rules, as it recently announced.

Providers must adopt mHealth to survive in today’s competitive marketplace. Not only will they reap the short-term benefits of higher revenues through Chronic Care Management and attracting new patients, but they will also build the secure infrastructure and tools needed for long-term success. mHealth will be critical to population health and health information exchange, two eventual destinations for the healthcare industry. Providers who adopt mHealth now will be ready for when our industry makes the complete shift toward a population-focused, value-based care model.

In my experience at The Breakaway Group, A Xerox Company, effective adoption begins when leaders engage their workforce in the vision and mission of the project; when education is focused, accessible, and targeted; when performance is measured, collected, and analyzed; and when adoption is sustained amid changing technologies and process improvements. For providers to make the transition successfully healthcare leaders must find and implement technologies that patients and providers want to use. They must provide education that is convenient, focused, and practical for providers, education that spans not only how to optimize the technology but also how to use it safely and in accordance with government regulations. Healthcare leaders must also track performance in quality and efficiency, and highlight areas for improvement. And lastly, they must ensure all efforts are sustained, reinforced, and tailored to changing needs.

mHealth is poised to transform healthcare. It’s no wonder that mHealth raised $1.2 billion in venture capital last year, or more than triple what it raised in 2013. I’d venture to say that a significant share of new patients, new revenues, and new efficiencies will be earned by providers who are going “mobile.”

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I thought it would be fun to look at a bunch of Healthcare IT Superlatives (best, scariest, cutest, smartest, funniest, etc etc etc). I imagine this will be a series of blog posts that never stops. If you’d like to see me write about a specific healthcare IT superlative, let me know in the comments or on my Contact Us page. I always like to cater to readers. Then, I at least no one person will find the post useful. Although, if one person finds it useful, it’s very likely that thousands of others are interested as well.

The first Healthcare IT Superlative we’ll consider is: Scariest Health IT Regulation

This is a challenging topic since healthcare is so burdened by regulation. I’m going to use a pretty broad interpretation of what I’d consider a healthcare IT regulation, but I’ll admit that I’m not as familiar with the medical device or pharma industry regulation. If you have experience in either of those, I’d love to hear what regulations in those industries is the scariest regulation.

When I think about all the various healthcare IT regulations, I have to narrow the scope down to the regulations that have the most over arching reach. That basically leaves me with ACO/Value Based Reimbursement, Meaningful Use, and HIPAA. Certainly there are plenty more that could be listed, but it’s not as scary for me if they aren’t large regulations that impact the majority of the healthcare system.

Of all of these, I’m most scared of ACO/Value Based Reimbursement. The worst part of any regulation is ambiguity. ACO and value based reimbursement is so vague right now that I don’t think anyone know where it will really end up going. That’s really scary for me and is likely scary for most healthcare organizations. It’s really hard to plan for something that’s vague and ambiguous.

Furthermore, the move to value based reimbursement and ACOs is likely going to have the biggest economic impact on healthcare. This doesn’t mean that every doctor and healthcare organization is going to lose when it comes to value based reimbursement. Definitely not. There are going to be a bunch of winners and losers. Some will really benefit from ACOs and some will suffer. However, my gut tells me that there’s going to be more losers than winners. That’s pretty scary to consider with all the other challenging dynamics at plat in healthcare today.

There you have it. What healthcare regulations are scaring you the most? Which regulations keep you up at night? I look forward to hearing your thoughts.

The Managed Care movement dramatically transformed healthcare in the 1990s. For the first time, our industry discovered increased margins by conserving the services we provided. Now, Population Health Management (PHM) is on the brink of transforming healthcare yet again—and perhaps in a more dramatic fashion. The transformation is already underway, with industry-wide consolidations between hospital networks, physician practices, and even insurance companies; government reforms targeting cost and quality controls; and new breeds of health organizations, professionals, and technologies.

Today’s PHM movement presents the same cost benefit as healthcare’s traditional models with a greater focus on health outcomes. The philosophy behind PHM is that healthcare providers and organizations will save money and improve care by identifying and stratifying patients with high, medium, and low risk for developing chronic conditions. Once patients are assigned a level of risk, care plans are then developed and deployed to treat them appropriately. For high-risk patients, strategic interventions are provided that reduce hospital admissions, readmissions, and complications. For low-risk patients, preventative care is offered to maintain health and avoid costly conditions. The PHM model requires broad-scale data collection, analysis, and transmission between healthcare entities—the latter not yet possible with the lack of integration between electronic health record (EHR) systems. PHM also calls for redesigning processes, discovering gaps in care, and extending patient-provider interactions beyond clinical events to encourage healthy life behaviors.

In order to reach the level of data collection needed for successful PHM, healthcare organizations must first adopt their EHR. Doing so makes it possible to intercept data, analyze it, and transform it into useful clinical information delivered to the point of care. Without EHR adoption, the most foundational elements of PHM cannot be supported: We cannot efficiently discover gaps in our current care, identify and stratify at-risk patients treated by an organization, or improve our processes to lessen the new financial risks of value-based care. EHRs are so central to PHM that overlapping incentives for both initiatives were proposed in November 2011 by the Centers for Medicare & Medicaid Services (CMS). The technology is also a necessary tool for Accountable Care Organizations (ACOs), which are a form of PHM. The Agency for Healthcare Research and Quality (AHRQ) published an interview with Dr. Stephen Shortell, a Distinguished Professor of Health Policy and Management at the University of California, who outlined aspects of EHR adoption as being essential to the success of ACOs.[“The State of Accountable Care Organizations.”The Agency for Healthcare Research and Quality. http://www.innovations.ahrq.gov/]

Our research at The Breakaway Group (TBG) points to four crucial components needed to adopt an EHR for PHM. Strong leadership must inspire continual engagement from users to embrace the EHR as a tool for positive change. Targeted and effective education—creating system proficiency in role-based tasks—must also be established before and after the EHR go-live event. Performance must be gauged, measured, and analyzed to enhance EHR use and establish governance measures. And with the evolutionary nature of the EHR, all optimization efforts must be sustained and refreshed to meet new challenges, such as application upgrades and process changes.

Although the PHM movement is relatively new, there are numerous examples of the model’s success. ACOs enrolled in CMS’s Shared Savings and Pioneer ACO programs have generated $380 million in savings.[“Medicare’s delivery system reform initiatives achieve significant savings and quality improvements – off to a strong start.” US Department of Health and Human Services. www.hhs.gov.] One Pioneer ACO, Partners HealthCare, has established patient-centered medical homes that employ Care Managers specializing in customizing patient care plans.[“Patient-centered Medical Home: Role of the Care Manager.” Partners HealthCare. www.partners.org.] While Partners HealthCare is not employing true PHM in the sense of sharing information with other healthcare entities, it is large enough in size to perform broad-scale data collection that can help better manage health populations. This example demonstrates the potential effect of PHM on our industry when data becomes transferrable.

EHR adoption is an essential feat we are capable of achieving now. Doing so is the first step toward learning more about the populations we serve, how we’re not serving them, and how we can adjust our processes to succeed in a value-based model. Yet to manage populations effectively, more is required from us, including being willing to work together in our pursuit of a better, brighter healthcare system. If we can overcome these hurdles now, then we will arrive ready for when our industry is capable of embracing true care coordination.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Tell us about Medical Management Corporation of America (MMCOA).
MMCOA helps physicians and physician groups increase collections, assure compliance, manage overhead and navigate the maze of EMR/EHR, Meaninful Use, PQRS and other Government incentive programs and regulations. With a focus on revenue cycle management, MMCOA helps our clients stay ahead of the curve with things like the transition to ICD-10.

What are the keys to running a good medical billing company?
Like any successful business, I believe the 2 most important assets are people and systems. We hire, retain and cultivate quality individuals and empower them with state of the art systems and technology. We never settle for status quo and continue to look for better ways of doing things. My style of leadership is one of servitude. It is my goal to provide all staff members a great work environment, financial incentives and proper tools to perform their functions.

What’s your take on the economics of outsourcing medical billing? Where’s the ROI for an office that’s considering going with an outside medical billing company like yours?
I tell physicians, “do what you do best and outsource the rest”. Your tax work is handled by a professional accountant, your legal work is handled by a professional attorney, who is handling your billing? Outsourcing your billing can sometimes be more expensive than keeping it in-house, however, the return should far outweigh the added cost.

Most practices do not have adequate resources in their billing department to do the right job. A great deal of money winds up being left on the table. There is a reason that the tallest buildings in most metropolitan cities are owned by insurance companies. A quality billing company will increase your collections at a rate that will far exceed the fee.

In addition, because the typical fee structure is based on a percentage of collections, not only does the billing company have “skin in the game” to do a good job, the billing overhead of the practice is better managed. If one or more physicians are out of the office on vacation resulting in lower charges, that eventually results in lower collections. With billing in-house the practice still pays salaries, benefits, software licenses etc. All the fixed costs remain in place regardless of collections that month. With outsourced billing company, the practice’s cost for billing is directly in proportion to the amount collected that month.

What are some of the biggest changes to medical billing that have happened over the past couple years?
EMR/EHR, PQRS, ePrescribing, HIPAA, Meaningful Use, Accountable Care Organizations, Value/Quality based reimbursement, Bundling, Health Insurance Exchanges, added governmental regulations, OIG compliance and soon…..ICD-10, ICD-10, ICD-10. ICD-10 will prove to be the biggest challenge to date. We’re ready!

How is medical billing going to be impacted by things like ACOs (Accountable Care Organizations) and value based reimbursement?
Someone will still need to make sure that services rendered are reimbursed properly. More challenging, someone will need to distribute funds appropriately to the myriad of providers involved. There will be a greater need for revenue cycle management as payments are bundled.

Is healthcare ready for ICD-10? What are you doing to make sure you’re ready?
Our research to date says no. Providers and staff are not yet trained. Insurance carriers and software vendors have not yet successfully tested.

We have established an ICD-10 committee headed by our Director of Healthcare Informatics. We have begun informing and educating our clients and staff, researching tools, attending training sessions, initiating dialogue with our software vendors and staying up to date.

In what ways has the Accountable Care Act (Obamacare) and the health insurance exchanges impacted your clients?
I’d say that it’s caused a whirlwind of confusion. Providers must take the time to determine which HIX plan networks they’re in, so as not to provide care outside of a contracted relationship with the HIX plans, which predominantly lack out-of-network coverage. We expect our clients to become busier. We expect the additional covered lives to find their way into our clients’ offices. We have helped our clients figure out if they are participants in the Exchanges in their area.

A number of EHR companies have started doing medical billing. How do you differentiate the services you offer versus an EHR vendor?
Most of the EHR vendors that have just started doing medical billing, just started doing medical billing. MMCOA has been in business for 18 years, growing primarily by word of mouth. Some of the EHR vendors are publicly held companies whose most important stake holder is their shareholders. Our most important stakeholder is our clients. We have had clients leave us for those solutions and have since come back. We will continue to provide quality service on a consistent basis and will never sacrifice integrity for growth.

What are the biggest revenue cycle management issues you see in organizations?
Not enough staff. Outdated or inadequate technology. Lack of leadership. Lack of ongoing training. Lack of incentive.

Where do you see revenue cycle management going in the future?
My crystal ball is broken right now. Seriously though, there is a lot of consolidation in our industry and the smaller billing companies will likely go out of business or be acquired. Physicians and physician groups will continue to need assistance with their reimbursements. Unless all healthcare providers wind up employed by an ACO, Hospital System or other Healthcare entity with adequate revenue cycle management expertise, there will be a need for continued navigation of the maze we know as healthcare revenue cycle management.

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

When it comes to keeping patients happy, EMRs matter, a new study suggests.

More patients are logging on to access their own records – and they tend to like it, according to data from research firms Aeffect and 88 Brand Partners. About 24 percent of patients have used EMRs for tasks such as checking test results, ordering medication refills and making appointments. And 78 percent of those patients reported being satisfied with their doctors, compared with 68 percent of those who hadn’t used EMRs.

“EMR users are telling us that they are more confident in the coordination of care they’re being provided, and think more highly of their doctors, simply because of the information technology in use,” Michael McGuire, director of strategy for Chicago-based 88 Brand Partners, said in a press release.

Patient satisfaction is fast becoming a top priority in health care as it determines a growing portion of providers’ reimbursement. So far, it’s mainly been an issue for hospitals. Their patient satisfaction survey results make up 30 percent of their quality score in Medicare’s “value-based purchasing” program, part of the Affordable Care Act. In fiscal 2013, hospitals saw 1 percent of their Medicare reimbursement put at risk based on the overall score, which also considers performance on clinical measures. The figure will increase to 2 percent by fiscal 2017. Private insurers are also starting to link payments with quality scores.

The trend is now taking hold outpatient clinics, as well. About 2 percent of primary-care doctors’ compensation is tied to patient satisfaction measures, and the figure is likely to grow in coming years, according to a recent report from the Medical Group Management Association. Specialist physicians reported, on average, that 1 percent of their salary hinged on patient satisfaction.

Patients cited several reasons for preferring that their doctors use EMRs, according to the EMR Patient Impact Study from Aeffect and 88 Brand Partners. Among them were ease of access to information and the perceived clarity and thoroughness of communication that the records systems provide. And adoption rates could be set to go higher: 52 percent of survey respondents said they aren’t using an EMR yet, but would be interested in trying one. Only 18 percent said they had no interest.

A host of other factors, such as level of attention and ease of making appointments, also factored into patient satisfaction, according to the survey of 1,000 consumers. But for doctors who have implemented EMRs, getting their patients to log on might be a simple way to create a more loyal following. In many cases, according to the survey, EMR-using patients had adopted the technology after being encouraged by a physician.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

They have made this mu reporting so bad….as our doctor says…they do not want doctor’s to practice by themselves…They are doing all they can to get them into ACOS…

The above is a quote from an EMR and HIPAA reader who emailed me about the meaningful use requirements. The conclusion was what really caught my attention. There are a number of questions that should be asked based on the statement above.

Does the government want doctors to not practice by themselves?
No one in government would say this and this isn’t their thought process at all. What they do want to see is a reform to how we pay for healthcare. If that means that doctors no longer practice on their own, I think they’re ok with that. I don’t think that’s the conclusion they’ve come to yet, but I think that’s what the reader is insinuating in the above comments. Personally I think it will be a tragedy for the physician community if we no longer have solo doctors and small group practices.

Does the government want all doctors in an ACO?
Absolutely. They are pushing accountable care organizations and anything that will get us away from the fee for service model that we have today. Right now they think that ACOs are the path to get to a pay for performance system. That means they need every doctor in an ACO for it to work.

Is meaningful use designed to be hard to encourage doctors to move to ACOs?
No. Meaningful use was designed to be as hard as they thought they could possibly make it and still get a large number of doctors to do meaningful use. Of course, meaningful use’s intent is all about creating some accountability for the EHR incentive money. However, there’s little doubt that some of the other government goals have been incorporated into meaningful use in the process.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Eligibility for Pay-for-Performance
I think that this is a really scary topic for most doctors. It’s not that a doctor is afraid of being reimbursed for the way they perform. The problem with pay for performance (ACO if you prefer) is that we have no idea what that’s really going to look like. The unknown is scary and a real problem. A change as dramatic from fee for service to pay for performance is an enormous shift and we still have very little idea how that shift is going to happen.

However, as one person told me, “That train (the shift to pay for performance) has already left the station.” In fact, I was talking with the former CEO of a major EMR vendor and he suggested that the shift is going to happen a lot faster than most of us realize. If we assume that this shift is going to happen, then doctors and healthcare better be prepared.

I believe having an EMR will be the only way a clinic can participate in pay for performance.

I make this assertion, because how else are payers going to measure your performance if they don’t have the data on how you’re performing? I’ve never thought of this before, but the EMR could become the performance measurement tool for doctors. Trying to flintstone your performance in a paper world is just not going to happen. The data collected in an EMR (and possibly other software) is going to drive the performance metrics which will drive the payments.

Think about what that means to a clinic. If you don’t have an EMR, you will miss out on the pay for performance payments.

I imagine many that read this will discount the shift that’s going to happen. That’s a fair position to take, but one that I think will come back to bite you. If the shift in payments doesn’t happen, then you won’t have to worry. However, if the shift to pay for performance has left the station, then you’re going to be at a tremendous disadvantage.

Healthcare data is going to drive a lot of things in the future of healthcare. Pay for performance is one of those things. Physicians who don’t have that data available in an EMR or other electronic format are going to face stiff challenges.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the beauties of TEDMED is that they do a really professional job recording the event and sharing the recorded video with the world. For those who missed it or want to re-watch certain sessions, you can find the full TEDMED session recordings available online. Thanks to Xerox, I was able to cover the event in person. If you’re looking for a cliff notes version of TEDMED, check out my previous posts covering the event:

As I think back on TEDMED, I’m stuck wondering about a major healthcare group I would have loved to see on the TEDMED stage: hospital and healthcare administrators. No doubt they’re doing some really innovative things in healthcare, but yet we didn’t see any of them on stage talking about how to innovate the nuts and bolts of healthcare.

It’s not that many of these hospital and healthcare administrators weren’t at TEDMED, because they were there in force. I met with many of them and saw many of them tweeting about TEDMED like this tweet from New York Presbyterian CIO, Aurelia Boyer:

Back at ranch #TEDMED may be having more effect on how I see things than I thought it would.

I hope that many more hospital and healthcare administrators will “Step Out” and speak at TEDMED like Hospital CIO Bill Reiger did at The Breakaway Group’s Healthcare Forum at TEDMED. It’s great that hospital and healthcare administrators are listening and learning at TEDMED, but they also have a voice that needs to be heard.

Looking forward to the next year in healthcare let me suggest three topics I hope we’ll find at TEDMED 2014:

Accountable Care Organizations (ACOs) – ACOs represent the core of a rapidly changing healthcare reimbursement environment. This change will fundamentally alter healthcare as we know it. ACOs are a hard topic to package into a slick presentation, but there are stories to be told about the impact for good and bad of ACOs. We often hear: “If you’ve seen one ACO, you’ve seen…one ACO.” How about we start with one ACO TEDMED talk and expand from there?

Interoperability – Almost nothing could provide more value to healthcare than true data interoperability. There are literally hundreds and possibly thousands of people affected every day by the lack of healthcare interoperability. The challenges to interoperability are real and powerful, but I see a shifting tide where organizations are finally looking to embrace interoperability and its inherent benefits. TEDMED would be the perfect place to highlight the interoperability success stories that will inspire others to follow.

Patient Engagement – A number of sessions at TEDMED 2013 began the discussion of the shifting role of patients in healthcare. I won’t be surprised if 2014 becomes the Year of the Patient. Like a slow moving ship that’s impossible to stop, the patient is finally becoming the center of healthcare. ZDoggMD’s comment at TEDMED highlights this shift from the physician perspective, “I went in to medicine to do things for patients, not to patients.” Patients at the center of healthcare is a message that needs to be shared.

In true TEDMED form, it only seems appropriate that I also suggest a collaborative musical act that could perform at a future TEDMED. If you’ve never heard of The Piano Guys, they’re great. Where else have you seen a piano and cello collaboration perform Coldplay, Usher, and Adele? Although, their real genius is when they take two songs and mix them into one beautiful piece like they did with Love Story Meets Viva La Vida. I can think of a few areas of healthcare that could benefit from some unexpected collaboration.

What did you take away from TEDMED 2013? Have you had a change in perspective personally or professionally? What topics should we see at future TEDMED events?

You can hear more reflections from TEDMED and predictions for the future of healthcare during the May 2 at 2 p.m. ET “Xerox ‘Ask the Experts’ Episode: Looking Ahead After TEDMED” Google+ Hangout that I’m hosting and participating in. Click here for more details and to watch.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The past couple days, I’ve been at the CHIME Fall CIO Forum in Palm Springs. This is my first time attending the event and it’s been an eye opening experience to say the least. It’s an amazing experience to have casual conversations with many in the healthcare IT industry and particularly with hospital CIOs.

While chatting with a former hospital CIO who now is on the vendor side, he made this fascinating observation:

I travel around and talk to a handful of CIOs every week as part of my job. When I meet with these hospital CIOs and hear about the challenges they face in their institution, I don’t get the feeling “That’s a really swell place to work. I want that job.”

In this current economic climate, it’s hard for anyone to feel really bad for a well paid hospital CIO (Yes, some are better paid than others). I acknowledge that many around the country would argue that a hospital CIO should be glad to have a job, and one that pays above the national average salary.

This general economic argument aside, I think it’s worth noting the challenging situation that many hospital CIOs face. Regardless of how much someone is paid, that doesn’t change the enormous challenge that most hospital CIOs confront every day.

Yes, we could start with the list of alphabet soup including: meaningful use, EHR, ACOs, 5010, HIE, and ICD-10 to name just a few. However, that’s just the beginning of what they’re dealing with in their jobs. Another major one worth mentioning is managing the budgets. It’s a complex, high pressure job whenever money is involved. Add in all the various maintenance, people management, process management, etc etc etc and the hospital CIO has a tough job.

This has never been more clear to me than at CHIME where the hospital CIOs all come and commiserate. I don’t think we should feel bad for these hospital CIOs and I don’t think they’re asking us to do that either. Although, it’s worth acknowledging that hospital CIOs face a tough and challenging job and I don’t see that changing any time soon. I appreciate those that are willing to take up the challenge and that perform so well in the face of such a changing environment.

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